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Preoperative logGAR Predicts Postoperative Complications in Pediatric Cardiac Surgery: A Retrospective Cohort Study

Min-Xiao Li1, Yu-Zhen Zhang1, Bo Feng1

  • 1Department of Anesthesiology, Kunming Children's Hospital, Yunnan, China.

Journal of Cardiothoracic and Vascular Anesthesia
|November 6, 2025
PubMed

Insights

The preoperative gamma-glutamyl transferase-to-albumin ratio (logGAR) can predict anesthesia-related complications in children undergoing congenital heart disease (CHD) surgery. Higher logGAR levels indicate increased risk for adverse outcomes like prolonged ventilation and ICU stay.

Area of Science:

  • Pediatric Anesthesiology
  • Cardiovascular Surgery
  • Biomarker Research

Background:

  • Anesthesia-related complications are a significant concern in pediatric congenital heart disease (CHD) surgery.
  • Prolonged mechanical ventilation, reintubation, and extended ICU stays are common adverse events.
  • Identifying predictive markers for these complications is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the preoperative gamma-glutamyl transferase-to-albumin ratio (logGAR) as a predictor of anesthesia-related complications in pediatric CHD patients.
  • To assess the association between logGAR, reflecting oxidative stress, inflammation, and nutritional status, and postoperative complications.

Main Methods:

  • Retrospective cohort study including 942 pediatric patients undergoing cardiopulmonary bypass for CHD (2018-2024).
  • Calculation of preoperative logGAR.
  • Analysis of primary outcomes: mechanical ventilation ≥72 hours, reintubation within 48 hours, ICU length of stay >90th percentile, or mortality.

Main Results:

  • 17.4% of patients (164/942) experienced complications.
  • Preoperative logGAR was significantly higher in patients with complications (median -0.97 vs. -1.32, p < 0.001).
  • Each unit increase in logGAR correlated with increased complication risk (aOR 2.41; 95% CI 1.49-3.95), with the strongest association observed between -1.62 and 0.467.

Conclusions:

  • Preoperative logGAR is a significant predictor of anesthesia-related complications following pediatric CHD surgery.
  • Incorporating logGAR into preanesthetic evaluations may enhance perioperative risk stratification for these vulnerable patients.
Abstract

Keywords:
albuminanesthesia-related complicationsgamma-glutamyl transferaselogGARpediatric cardiac surgeryperioperative risk stratification

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